Health Insurance and You!

This rule is very similar to rule 2 — but is very easy to miss.

Let us start with the obvious — when you buy a health insurance plan, of course you want to choose one that your local hospital accepts. But many consumers are not either thinking about getting sick or may not know what hospitals are near them.  If you do not know which hospitals are really near you, then use this tool to find out what hospitals are near you.

Next, make sure your health insurance counselor uses this information to select a plan that covers nearby hospitals.

Chini Krishnan

http://www.getinsured.com/

Telling the truth is generally always a good idea, but especially so in a health insurance application.

When you buy health insurance, you are entering into a contract. The essence of the contract is that  you pay daily amounts (called premiums) in exchange for your insurer agreeing to pay for certain (and hopefully most) of your medical expenses.

But there is a catch — if you lie or misrepresent your health status, your insurer may retroactively cancel your coverage.  This is truly a terrible situation to be in because you could be denied valuable coverage at the time your greatest need.

Don't let this happen to you.   If you have a situation, discuss it confidentially with your health insurance counselor first.  

Chini Krishnan

http://www.getinsured.com/

The Wall Street Journal reported today that the Sentate Finance Committee has endorsed the idea of creating a National Health Insurance Exchange.

In particular, the committee conceives of the Exchange as an Internet portal that would allow consumers to compare health insurance plans available to them.

Momentum for this approach clearly continues to build — and yet, there are many important questions about this Exchange that remain to be answered.  In an effort to to help debate the issues around this Exchange more clearly, we are delighted to sponsor a public domain initiative — effective immediately,  we are launching a prototype for the National Health Insurance Exchange on http://www.getinsured.com/nhie. 

As you will see from the Exchange — the effort is nascent and our goal is to help understand how the various stakeholders — health insurers, citizens and regulators interact with each other in meaningful ways.

Please do join us in this important effort and contribute your thoughts and ideas.  

Chini Krishnan

http://www.getinsured.com

Is the National Health Insurance Exchange conceived as a regulatory entity or do lawmakers think of it as an entity that actually provides services for Americans to directly purchase health insurance, obtain customer support, collection of premiums, plan fulfillment and so on?
 

By way of background, a prominent example of a Connector exists in the state of  Massachusetts with the Massachusetts  Connector Program.  Senator Baucus, who chairs the Senate Finance Committee, has strongly implied that he believes the Exchange would be a transacting,entity providing support to Americans.  The National Association of Health Under-writers  (“NAHU” — the trade organization representing licensed health insurance agents) has indicated that  they are not wholly opposed to the creation of an Exchange as a transacting entity (with some important qualifications, read the full testimony of Janet Trautwein, NAHU CEO,  to Congress in April 2009.)  

We believe that the broad creation of Exchanges will dramatically alter the landscape of how health insurance is sold and serviced. On one hand, Americans will benefit from having a single common online place in their state where they can buy plans. Large employers and advocacy groups may offer their own connector, which may make it particularly useful as well.  

If  however, as the majority of our customers do, you are accustomed to having a licensed health insurance agent walk you through your choices, then the likelihood that such a person would continue (in a world where Connectors are ubiquitous) to have the incentives to provide you service is low.  We do view this with significant concern – we speak to hundreds of Americans consumers each day and believe that the lay consumer does not understand the health insurance terms and needs help in choosing a health insurance plan that is right for them. This need is not going away magically simply because we direct them to a new web-site tomorrow. 

Thus, in a world of Connectors, it is critical to answer the question of how we leverage technology to provide expert systems, services, online wizards and other tools for Americans to  allow them to navigate to the right plan.  We for one, believe this issue is overlooked as a second order issue in the healthcare reform debate and deserves not to be.   

 Chini Krishnan

Founder and CEO 

www.getinsured.com  

The National Health Insurance Exchange

Many Americans may not realize it but Congress may be about to change the way they buy health insurance in profound ways.  Its called a “National Health Insurance Exchange”.

Congress (led by the Senate Finance Committee chaired by Senator Max Baucus) has proposed an online exchange where Americans and Small businesses can better understand and possibly purchase health insurance from an approved list of vendors.   The most important details regarding these, are however, extremely sketchy.  As we move forward, we would like to understand the answers to three questions:

1. Is the Exchange conceived as a regulatory entity or an entity that supports actual purchase transactions by citizens and businesses?
2. Is there one national Exchange or does each state have its own Exchange? Can large businesses or associations form their own Exchange?
3. Will an Exchange ultimately help or hurt the average consumer?

Chini Krishnan
Founder and CEO
www.getinsured.com

This one sounds so obvious and yet most people miss it.  If you are looking to buy health insurance, you fall into one of two situations:

Case 1: You do not have a family doctor or specialist. Alternatively, even if you have one, you are not particularly attached to seeing that doctor. If this is true, then you can safely ignore the rest of this post.

Case 2:  You do have a family doctor and would very much like to continue seeing that doctor.  If you fall into this category, then remember this – not all doctors accept every plan.  If you buy a health insurance plan and then find out later that it does not cover your doctor, you could lose hundreds of dollars in out-of-network costs each year.

So, if you do have a family doctor and would like to keep him or her – please do ask your health insurance counselor to choose a plan that covers that doctor!

Chini Krishnan 

John Smith (name changed) called us yesterday and needed to obtain health insurance for his family.  Unfortunately, Jane (John’s wife) is diabetic, which would disqualify her from most well branded health insurance carriers.  John’s family would be considered “split” – in that John and the children would qualify for health insurance, but Jane would not.

How did we help this family? First, we split the family into two separate applications – John and the children on one plan (as it happens, a plan from Aetna) and Jane on to an accident medical plan.

There are some who question the wisdom of this approach — because we could not find Jane a program where she would be fully covered. However, I believe it was absolutely the best decision under the circumstances. By creating two separate applications, we got John and the kids into the best plan they could possibly hope for.  As it relates to Jane – we really have only two meaningful choices – the first is to do nothing.  The second is to provide Jane protection for health expenses that may result from an accident and/or supplement it with discount programs. This type of coverage is usually inexpensive (under $30/month). The latter is what we chose to do.

Many others in Jane’s situation have taken a more expansive approach and signed up for guaranteed issue health insurance plans that cover more than an accident. We absolutely do not encourage such alternative approaches when a customer qualifies for major medical insurance and can afford it.  But when a customer does not, we believe it is a better choice to service the customer's need than give up.

The wonderful service counselors who form part of getinsured.com can provide each of you this service – at no cost.  We believe this guided approach is much better than looking at web pages with hundreds of health plans. We also believe it is better than talking to a local Life and auto broker who may just offer one health insurance plan or two and has no fundamental focus on health insurance.

This post is part of a series — where we will build a series of consumer tips for purchasing health insurance well.  Is there anything you would like to hear about? 

Chini Krishnan
www.getinsured.com
Founder and CEO

Health Insurance can be scary, confusing and unaffordable. I’d like to start by acknowledging this basic truth that millions of Americans live every day.  We talk to thousands of Americans each day and I’d like to give voice to some real issues affecting individuals and families who don’t get health insurance as part of their employer’s plan.

• Health insurance can be hard to afford – the average consumer plan that we provide each day costs about $180.00 per month – this is a significant component of the family budget.
• If you have diabetes or many other conditions, most health plans will not accept you. 
• You don’t know if you are getting a good deal – even when you can qualify for health insurance and can afford it, it is hard to know what the best value plan for you is. Most people have a hard time understanding and managing their health policies.

Welcome to my blog, whether you are a consumer, a policy maker or part of the health insurance industry.   Our goal here is to understand the many dimensions of the health insurance crisis and how technology, policy and markets can help the American consumer.

Chini Krishnan
Founder and CEO
www.getinsured.com